Course Name: Advanced Principles of Revenue Cycle Management
Course Prefix: HIM
Course Number: 3610
Submitted by (Name & E-Mail): Pat Shaw, pshaw@weber.edu
Current Date: 10/27/2013
College: Health Professions
Department: Health Admin Services
From Term: Summer 2014
Substantive
new
Current Course Subject N/A
Current Course Number
New/Revised Course Information:
Subject: HIM
Check all that apply:
This is for courses already approved for gen ed.
Use a different form for proposing a new gen ed designation.
Course Number: 3610
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Course Title: Advanced Principles of Revenue Cycle Management
Abbreviated Course Title: Advanced Principles of RCM
Course Type: LEC
Credit Hours: 3 or if variable hours:
Contact Hours: Lecture Lab
to
Other
Repeat Information: Limit 0 Max Hrs 0
Grading Mode: standard
This course is/will be:
a required course in a major program
a required course in a minor program
a required course in a 1- or 2- year program
elective
Prerequisites/Co-requisites:
HIM 2330 or Instructor approval
Course description (exactly as it will appear in the catalog, including prerequisites):
Elements of the revenue cycle are reviewed. Principles of revenue cycle management are examined
including: scope and management of clinical coded data, process improvement and data quality,
compliance, internal and external auditing, reporting, case-mix management, and changes in revenue
cycle management.
Justification for the new course or for changes to an existing course. (Note: Justification should
emphasize academic rationale for the change or new course. This is particularly important for
courses requesting upper-division status.)
This course will build on knowledge gained from previous reimbursement and coding courses (HIM
2300, HIM 2320, HIM 2330 and HIM 2410). Students will develop skills in claims management,
auditing, compliance with regulatory, HIPAA, Office of the Inspector General requirements, and
Recovery Audit Contractors for healthcare reimbursement and claims. There is a need for formal
education in our region and the addition of this course will provide individuals with the education
necessary to earn expert level certifications in coding or clinical documentation improvement.
This course will be an elective course for students in the BS degree in HAS: Health Information
Management. The addition of this course will provide students who transfer to Weber from other
associate degree programs in HIM the opportunity earn upper division credit in their area of interest
and concentration. This course will also provide the advanced coding, auditing and claims
management knowledge and expertise to advance career opportunities and earn expert-level
certifications. This course will be marketed to graduates from our Institutional Certificate in Health
Care Coding and our AAS degree program in Health Information Technology as well as individuals in
the healthcare industry.
INFORMATION PAGE
for substantive proposals only
1. Did this course receive unanimous approval within the Department?
true
If not, what are the major concerns raised by the opponents?
2. If this is a new course proposal, could you achieve the desired results by revising an existing course within
your department or by requiring an existing course in another department?
No, because this course will go beyond what is taught in all existing courses.
3. How will the proposed course differ from similar offerings by other departments? Comment on any subject
overlap between this course and topics generally taught by other departments, even if no similar courses are
currently offered by the other departments. Explain any effects that this proposal will have on program
requirements or enrollments in other department. Please forward letters (email communication is sufficient)
from all departments that you have identified above stating their support or opposition to the proposed course.
No other course on campus teaches content in healthcare claims management.
4. Is this course required for certification/accreditation of a program?
no
If so, a statement to that effect should appear in the justification and supporting documents should accompany
this form.
5. For course proposals, e-mail a syllabus to Faculty Senate which should be sufficiently detailed that the
committees can determine that the course is at the appropriate level and matches the description. There should
be an indication of the amount and type of outside activity required in the course (projects, research
papers, homework, etc.).
WEBER STATE UNIVERSITY
DUMKE COLLEGE OF HEALTH PROFESSIONS
Health Administrative Services
HIM 3610 Advanced Principles of Revenue Cycle Management
Course Description:
Elements of the revenue cycle are reviewed. Principles of revenue cycle management
are examined including: scope and management of clinical coded data, process
improvement and data quality, compliance, internal and external auditing, reporting,
case-mix management, and changes in revenue cycle management.
Instructor: TBD
Text:
Schraffenberger, L., and Kuehn, L. (2011) Effective Management of Coding Services.
Chicago, IL: AHIMA. ISBN: 978-1-58426-234-2
Course Objectives: Upon completion of this course, the student will be able to:
1.
2.
3.
4.
Define and understand the components of the revenue cycle
Explain healthcare reimbursement methodology
Identify key components that effect the revenue cycle
Understand the complexities of the coding function and how it relates to the
revenue cycle, audits, reporting, and other key factors
5. Develop knowledge and skills in recruitment, staffing, and coding function
management
6. Describe the steps in performance and process improvement
7. Understand the importance of data quality
8. Define and explain the significance of compliance with state and federal laws and
regulations in regards to health information functions
9. Understand the auditing process and have experience responding to audits
10. Know how to access reporting regulations and understand the role that coded
data has in reporting
11. Understand the uses of coded data and the significance of the data
12. Define value-based purchasing and describe its importance in reimbursement
methodology
13. Understand case-mix methodology
14. Gain awareness regarding changing landscape of revenue cycle management
Course Schedule:
Week 1
Components of the Revenue Cycle/ Reimbursement Methodologies
QUIZ 1
Week 2
Structure and Function of the Coding Function
QUIZ 2
Week 3
Coding Staff Recruitment and Retention Issues/Alternate Staffing
ASSIGNMENT 1: Managing the Coding Function
Week 4
Coding in Specialized Care Settings
QUIZ 3
Week 5
Classifications and Terminologies/ Charge Description Master
QUIZ 4
Week 6
Performance/Process Improvement
QUIZ 5
Week 7
Coding and Data Quality
MIDTERM EXAM
Week 8
Compliance/Auditing
ASSIGNMENT 2: Responding to a RAC Audit
Week 9
Reporting
QUIZ 6
Week 10
Revenue Cycle Principles
QUIZ 7
Week 11
Case-Mix Methodologies
QUIZ 8
Week 12
Uses of Coded Data
QUIZ 9
Week 13
Value-Based Purchasing
ASSIGNMENT 3: Revenue Cycle Management
Week 14
Changing Landscape of Revenue Cycle Management
Week 15
Final Exam
Grading: Please see the assignment and examination pages for due dates. Grades
will be determined on a total point basis.
QUIZZES
270 points
ASSIGNMENTS
150 points
MIDTERM EXAM
80 points
FINAL EXAM
Total
100 points
600 points
Grading Scale for all HAS/HIM courses:
Percentage Grade
94-100% = A
90-93%
= A87-89%
= B+
83-86%
=B
80-82%
= B77-79%
= C+
73-76%
=C
70-72%
= C67-69%
= D+
63-66%
=D
60-62%
= DBelow 60% = E
Cheating/Coercion: Cheating and other coercion on course work that has not been
assigned as a group project will be dealt with using the WSU policy from the Student
Code handbook (see pages 7 and 8). Specific sanctions that typically apply to cheating
during test-taking or to cheating on class assignments are listed below.
1. Warning. A warning will be issued if the incident cannot be verified beyond a
reasonable doubt. A warning is a verbal or written notice to a student that his or her
conduct may be in violation of WSU rules and regulations and that the continuation of
such conduct or actions may result in further disciplinary action.
2. Grade reduction. Reduction by one full letter grade of the student's grade for the
course (for example, A- to B-, B to C, etc.) will be implemented if the student has
previously committed no verifiable acts of cheating.
3. Failure of course. A failing grade for the course will be implemented if the student
has previously participated in at least one verifiable act of cheating.
Incidents of cheating may be reported to other programs within the Dumke College of
Health Professions.
Student Accommodations: Any student requiring accommodations or services due to
a disability must contact the Services for Students with Disabilities (SSD) in room 181 of
the Student Services Center. SSD can also arrange to provide course materials
(including the syllabus) in alternative formats if necessary. For more information about
the SSD contact them at 801-626-6413.